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September 15, 1999

Chinese Herbal Medicine for Irritable Bowel Syndrome

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(11):1035-1037. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-11-jac90008

To the Editor: The clinical trial by Mr Bensoussan and colleagues1 on CHM for IBS is an innovative effort that respects the integrity of an alternative paradigm yet simultaneously manages to adopt the methodological safeguards demanded by scientific research. However, the answers to 3 questions are important in interpreting the results. First, how was the standardized herbal formula selected or devised? My examination of Chinese and English sources has not uncovered any similar prescription.2,3 Second, what were the exact herbs constituting the placebo? One needs to be vigilant about the possibility of a noninert placebo causing independent harmful or beneficial effects that could bias the outcome of a trial.4 Because there are no regulations for the composition of placebos, this can present a challenge in any clinical trial,5 but it may be especially problematic with herbal placebos. Finally, why do the ingredients of the standard herbal formula not add up to 100%?

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